NPIMap

Organization Active NPI

Cloverdale Road Family Medical Center

  • Family Medicine Physician
  • Florence, AL
National Provider Identifier
1265705065
Registry record updated Feb 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
8871 Issued in AL
Legal business name
CLOVERDALE ROAD FAMILY MEDICAL CENTER
Practice address
3502 Cloverdale Rd
Florence, AL 35633-1302
Phone
(256) 764-1263
Fax
(256) 764-9611
NPI assigned
Feb 10, 2012
Last updated
Feb 10, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Carolyn Leonard
Title
Controller
Phone
(256) 386-4673

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 8871 AL Primary

Addresses

Primary practice location

3502 Cloverdale Rd
Florence, AL 35633-1302

Mailing address

PO Box 895
Sheffield, AL 35660-0895
Phone (256) 764-1263

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1328832000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328832000000",
    "number": "1265705065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 895",
            "city": "SHEFFIELD",
            "state": "AL",
            "postal_code": "356600895",
            "telephone_number": "256-764-1263",
            "fax_number": "256-764-9611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3502 CLOVERDALE RD",
            "city": "FLORENCE",
            "state": "AL",
            "postal_code": "356331302",
            "telephone_number": "256-764-1263",
            "fax_number": "256-764-9611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLOVERDALE ROAD FAMILY MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-10",
        "last_updated": "2012-02-10",
        "status": "A",
        "authorized_official_last_name": "LEONARD",
        "authorized_official_first_name": "CAROLYN",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "256-386-4673"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "8871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Florence, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.